Israel says its troops have entered Al-Shifa Hospital in Gaza City

TEL AVIV, Israel — The Israeli military said early Wednesday that it is carrying out an operation against Hamas inside the Al-Shifa Hospital, the major complex in Gaza City that is the territory's largest medical center.

In a posting on social media, the Israel Defense Forces said it was launching "a precise and targeted operation against Hamas in a specified area" of the hospital complex. The IDF said the operation was being carried out based on intelligence information.

Israel had previously said that Hamas militants were embedded in the hospital, a claim that U.S. officials confirmed on Tuesday. Conditions in the hospital complex have recently worsened, as the complex has ran out of fuel to power its generators.

On Tuesday, the White House said its own intelligence showed that Hamas has used hospitals in Gaza, along with tunnels buried underneath, to plan operations and store weapons.

The U.S. intelligence appears to back Israeli claims about militant group activities underneath Gaza's hospitals — including Al-Shifa Hospital.

"We have information that Hamas and the Palestinian Islamic Jihad use some hospitals in the Gaza Strip, including Al-Shifa, and tunnels underneath them to conceal and to support their military operations and to hold hostages," said National Security Council spokesperson John Kirby, speaking to reporters aboard Air Force One.

For weeks, Israeli officials have said that Hamas is headquartered in an extensive network of tunnels buried underneath Al-Shifa. Hamas has denied the allegations.

As Israeli troops encircle the hospital in Gaza City, conditions there and at other medical facilities in northern Gaza have worsened to unimaginable levels, health officials and humanitarian groups on the ground say.

Hundreds of medical staff and patients remain in the Al-Shifa complex, Palestinian officials and aid groups say, along with thousands of Palestinians who have sought shelter from Israeli airstrikes there, although many have fled in recent days.

On Monday, President Biden called for "less intrusive action" around Gaza's hospitals as Israel's ground invasion continues.

"Hospitals must be protected," he said at the White House, adding that the U.S. is engaging in an ongoing effort to "get this pause to deal with the release" of some 240 hostages still held by Hamas.

On Tuesday, officials at Al-Shifa reported that the hospital had buried 170 people in a mass grave. Without power to operate incubators or other life-saving medical equipment, hospital officials say that bodies are decomposing in its courtyard and babies are dying.

There is no water or food for patients or staff at Al-Shifa, according to Palestinian health officials.

"Our staff is saying there is no electricity," said Paul Caney, an emergency coordinator for Doctors Without Borders, which has several medical teams working at the hospital. "People are staying in the corridors because of sniper fire near the windows and that they cannot move any of the patients to ambulances."

There are more than 600 inpatients at Al-Shifa, including 37 babies and at least one patient in need of an ICU, the organization said, citing one of its surgeons who is inside the hospital. The surgeon described the situation as "inhuman."

Hospitals have lost access to critical supplies

Hospitals have run out of fuel to power their generators, including Al-Shifa and Al-Quds in the north of Gaza, and have ceased to function as medical facilities.

Israel has blocked the delivery of fuel into Gaza, saying that Hamas has sufficient stores of fuel for hospitals and new deliveries could be stolen by militants.

Of the hospitals in northern Gaza, where fighting has been most intense, Al-Ahli Hospital "is reportedly the sole medical facility able to receive patients, amid increasing shortages and challenges," the United Nations Office for the Coordination of Humanitarian Affairs said.

Across Gaza, 22 of the territory's 36 hospitals are "non-functional due to lack of fuel, damage, attacks and insecurity," the World Health Organization said Tuesday.

Officials report a rising death toll as Israel continues its siege on the region in response to the Oct. 7 attacks by the militant group Hamas that killed 1,200 Israelis.

More than 11,300 Palestinians in Gaza have died, according to the Ministry of Health in Gaza. An additional 196 Palestinians in the West Bank have died since Oct. 7, Palestinian officials say.

For the third day in a row, the Ministry of Health said there have been challenges in updating the tally due to communications disruptions.

Without fuel, Gaza's youngest patients are suffering the most.

Al-Shifa ran out of fuel on Saturday, hospital officials say. Three premature babies have died since then, according to health officials in Gaza.

Early Tuesday, the Israeli military said it had offered to transfer incubators to Al-Shifa Hospital from a hospital in Israel in a display of what it said was the military's commitment to distinguish between civilians and Hamas fighters as its operations in Gaza unfold.

"The IDF [Israel Defense Forces] is willing to work with any reliable mediating party to ensure the transfer of the incubators," a military statement said.

The military also released what it described as a recording of a phone call between an IDF officer and the director-general of Al-Shifa Hospital in which the two parties apparently agree to the transfer of 37 incubators and four respirators for children. The authenticity of the recording could not be independently verified.

The continued fighting has also meant other injured patients and displaced Palestinians who fear evacuating to the south are crowded into hospitals in the north for shelter.

Israel says it has focused on some hospitals in Gaza because it says Hamas is operating from military facilities underneath them, an allegation Hamas denies.

On Monday, the Israeli military released a video showing what it claimed to be Hamas tunnels underneath Al-Rantisi Hospital. Israeli military officials said that they found weapons under the hospital, which they said is evidence of Hamas' operations there.

NPR cannot independently confirm these details. Hamas denies that it used the hospital as a military headquarters.

Gaza health officials said the basement was "included in the design of the hospital and includes the administration and hospital stores. It has become a shelter place for displaced people fleeing the bombing to take shelter inside the hospital."

One hospital still stands, according to aid and the U.N.

As northern Gaza's hospitals go dark, one facility remains: Al-Ahli Hospital, according to the U.N. and Palestinian health officials.

Through spotty connection over Zoom late Sunday, British-Palestinian Dr. Ghassan Abu Sitta told the press and international medical community that he is treating patients in a nearly impossible situation at Al-Ahli.

Sitta was speaking in a call organized by the Palestine Children's Relief Fund.

He said the hospital was dealing with more than 500 wounded and has just three operating rooms, no access to a blood bank, no morphine or ketamine to help patients deal with pain and physically and mentally exhausted staff.

"You know, I did an amputation on a 6-year-old yesterday, her arm and her leg. My colleagues were working in the other room on a kid with shrapnel in his abdomen," Sitta said. "And colleagues told me he has no surviving family. So now the family in the bed next to his are looking after him."

He compared the situation facing the doctors and nurses at the hospital to what medical staff were dealing with in World War I.

He said, "The situation is beyond dire."

Jaclyn Diaz and Greg Myre reported from Tel Aviv. Ruth Sherlock reported from Rome. Aya Batrawy reported from Cairo. Becky Sullivan reported from Washington, D.C.

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